{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T20:49:39Z","timestamp":1790282979366,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100007195","name":"Universit\u00e0 degli Studi di Napoli Federico II","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007195","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Esophageal perforation in Zollinger\u2013Ellison syndrome (ZES) is an exceedingly rare and life\u2010threatening manifestation of gastrinoma\u2010related acid hypersecretion. While peptic ulceration and severe reflux are recognized complications of ZES, perforation represents the ultimate consequence of uncontrolled hyperacidity. Evidence remains confined to isolated case reports with no prior systematic synthesis. A scoping review was conducted in accordance with PRISMA\u2010ScR and the Joanna Briggs Institute framework. A comprehensive search of PubMed, Embase, Scopus, and Web of Science was performed from database inception to September 2025. Eligible studies included any report describing esophageal perforation in confirmed or suspected ZES. Iatrogenic perforations were excluded. Data were extracted on patient demographics, clinical presentation, diagnostic modalities, management strategies, and outcomes.\n                    <jats:bold>S<\/jats:bold>\n                    even eligible cases published between 2001 and 2025 were identified. Patients were aged 44\u201363\u2009years (4 males, 3 females). The distal esophagus was affected in approximately 70% of cases, usually after chronic peptic injury; three patients (\u224843%) presented with spontaneous Boerhaave\u2010type rupture. Computed tomography was diagnostic in all cases, and endoscopy was used in six. Surgical repair with mediastinal drainage or T\u2010tube repair was the mainstay of management, while conservative therapy failed. Endoscopic stenting achieved successful leak control in one patient, whereas overall survival across all cases was approximately 86%, with one death due to delayed diagnosis and sepsis. Esophageal perforation in ZES represents a predictable but preventable endpoint of chronic acid injury. Rapid imaging, decisive surgical or endoscopic repair, and definitive acid suppression are essential to survival. Awareness of this rare complication among surgeons and gastroenterologists may facilitate early recognition and improve outcomes.\n                  <\/jats:p>","DOI":"10.1002\/jgh3.70323","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T04:41:52Z","timestamp":1769143312000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Esophageal Perforation in Zollinger\u2013Ellison Syndrome: A Scoping Review of Management and Outcomes"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3122-5531","authenticated-orcid":false,"given":"Agostino","family":"Fernicola","sequence":"first","affiliation":[{"name":"Department of Advanced Biomedical Sciences, Unit of Emergency Surgery Federico II University  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1926-5562","authenticated-orcid":false,"given":"Domenico","family":"Parmeggiani","sequence":"additional","affiliation":[{"name":"Department of Integrated Activities in Surgery, Orthopedy and Hepato\u2010Gastroenterology University of Campania \u201cLuigi Vanvitelli\u201d  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4315-7660","authenticated-orcid":false,"given":"Felice","family":"Crocetto","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Sciences of Reproduction and Odontostomatology University Federico II  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2315-0610","authenticated-orcid":false,"given":"Armando","family":"Calogero","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, Unit of Emergency Surgery Federico II University  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0151-8230","authenticated-orcid":false,"given":"Alessio","family":"Cece","sequence":"additional","affiliation":[{"name":"Department of Integrated Activities in Surgery, Orthopedy and Hepato\u2010Gastroenterology University of Campania \u201cLuigi Vanvitelli\u201d  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Romano","sequence":"additional","affiliation":[{"name":"ASL Naples 1, San Paolo Hospital Center  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Benassai","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery Federico II University  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5699-150X","authenticated-orcid":false,"given":"Gennaro","family":"Quarto","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery Federico II University  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1299-9192","authenticated-orcid":false,"given":"Michele","family":"Santangelo","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, Unit of Emergency Surgery Federico II University  Naples 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